Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 1437 | WV |
NPI | 1003849076 |
---|---|
Provider Name | Jeffrey Scott Bryson |
First Address | Barboursville, WV 25504-0716 |
Second Address | Huntington, WV 25704-2561 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2006 |
Last Update Date | 20/06/2012 |